From: Prenatal risk factors for Tourette Syndrome: a systematic review
Factors | Results (Cases vs. Controls)* | P value | Case number | Control number | Note | Reference |
---|---|---|---|---|---|---|
Demographic factors | ||||||
Mother's age | 25.69 (5.29) vs. 25.12 (5.2) | p = 0.33 | 92 | 460 | Matched analysis | Burd 1999 [11] |
20 (1.4) vs. 23 (3.4) | p < 0.01 | 25 | 25 | Khalifa 2005 [13] | ||
29.8 (4.5) vs. 29.6 | 66 | 1174999 | Adjusted for birth year | Shimada 2012 [20] | ||
TS: 28.9 (4.4), TS + ADHD: 28.1 (5.3), Control: 28.3 (4.1) | NS | TS: 45, TS + ADHD:60 | 65 | Motlagh 2010 [17] | ||
Father's age | 28.87 (6.25) vs. 27.78 (5.96) | p = 0.11 | 92 | 460 | Matched analysis | Burd 1999 [11] |
31.9 (5.0) vs. 32.7 | NS | 65 | 1174999 | Adjusted for birth year | Shimada 2012 [20] | |
TS: 30.9 (5.0), TS + ADHD: 30.2 (6.2), Control: 30.4 (5.0) | NS | TS: 45, TS + ADHD:60 | 65 | Motlagh 2010 [17] | ||
Mother's education | 12.90 (2.11) vs. 12.64 (1.92) | p = 0.24 | 92 | 460 | Matched analysis | Burd 1999 [11] |
Father's education | 12.69 (2.44) vs. 12.67 (2.15) | p = 0.96 | 92 | 460 | Matched analysis | Burd 1999 [11] |
Parent's education | TS: 15.5 (2.0), TS + ADHD: 14.9 (1.8), Control: 15.3 (2.0) | NS | TS: 45, TS + ADHD:60 | 65 | Motlagh 2010 [17] | |
Mean socioeconomic status | TS: 50.4 (2.7), TS + ADHD: 47.4 (10.6), Control: 48.5 (10.7) | NS | TS: 45, TS + ADHD:60 | 65 | Motlagh 2010 [17] | |
Socio-economic status, parental education or divorce rate | No difference (no data provided) | NS | 25 | 25 | Khalifa 2005 [13] | |
Marital status | 4/92 vs. 36/460 | p = 0.93 | 92 | 460 | Klug 2003 [14] | |
Pre-conception condition | ||||||
Major diseases before pregnancy or pre-existing medical conditions | (20/42 vs. 21/43) OR = 0.95, 95% CI = 0.41-2.23 | p = 0.91 | 42 | 43 | Kondo 1982 [15] | |
TS vs. Control (1/45 vs. 4/65); TS + ADHD vs. Control (4/60 vs. 4/65) | NS | TS: 45, TS + ADHD:60 | 65 | Motlagh 2010 [17] | ||
Pre-natal period | ||||||
Month prenatal care began | 2.47 (1.27) vs. 3.01 (1.40) | p = 0.001 | 92 | 460 | Matched analysis | Burd 1999 [11] |
Prenatal visits | 10.00 (3.57) vs. 8.51 (3.22) | p < 0.001 | 92 | 460 | Matched analysis | Burd 1999 [11] |
Prenatal care begun after first trimester | OR = 0.49 (0.27-0.90), (14/92 vs. 123/460) | p = 0.03 | 92 | 460 | Burd 1999 [11] | |
Minor physical anomalies (numbers) | 5.46 (2.15) vs. 1.11(1.18); Mann–Whitney U-test 49.50, -Z = -4.92 | p = 0.001 | 24 | 24 | Csabi 2008 [12] | |
Number of prenatal problems | Presence of ADHD, OR = 2.97, 95% CI: 1.27-6.94 | p = 0.02 | 180 | Mathews 2006 [26] | ||
Disordered pregnancies | (12/42 vs. 15/43) OR = 0.75, 95% CI = 0.30-1.87 | p = 0.53 | 42 | 43 | Kondo 1982 [15] | |
Any pregnancy complication | Male TS vs. Female TS: 63% vs. 83% | NS | 46 M | 7 F | Santangelo 1994 [19] | |
TS + OCD vs. TS: 67% vs. 65% | NS | 15 | 34 | Santangelo 1994 [19] | ||
One or more pregnancy complication | 17/51 vs. 9/51 (OR = 2.33, 95% CI = 0.92-5.89) | p = 0.07 | 51 | 51 | Pasamanick 1956 [18] | |
TS + ADHD: 27/60, Control: 16/65 | p = 0.01 | TS + ADHD:60 | 65 | Motlagh 2010 [17] | ||
TS: 17/45, Control: 16/65 | NS | TS: 45 | 65 | Motlagh 2010 [17] | ||
Maternal hypertension | TS + ADHD vs. TS, OR = 1.04 (95% CI: 0.44-2.42) | p = 0.93 | 181 | 172 | Unadjusted OR | Pringsheim 2009 [21] |
Severe psychosocial stress | TS vs. Control (10/45 vs. 5/62, OR = 2.6, 95% CI = 0.08-8.7, p = 0.11); TS + ADHD vs. Control (11/55 vs. 5/62, OR = 3.1, 95% CI = 0.9-11.1, p = 0.07) | p = 0.11 and 0.07 | TS: 45, TS + ADHD:60 | 65 | Adjusted for gender | Motlagh 2010 [17] |
Antibiotics exposure in pregnancy | TS: 11/45, TS + ADHD: 11/60, Control: 6/65 | both p < 0.05 | TS: 45, TS + ADHD:60 | 65 | Motlagh 2010 [17] | |
Medication/procedures | Male TS vs. Female TS: 37% vs. 50% | NS | 46 M | 7 F | Santangelo 1994 [19] | |
TS + OCD vs. TS: 27% vs. 44% | NS | 15 | 34 | Santangelo 1994 [19] | ||
Number of medications exposed to in utero | Presence of ADHD, OR = 0.50, 95% CI: 0.25-1.00 | p < 0.05 | 180 | Mathews 2006 [26] | ||
Maternal smoking (>10 cigarettes/d) | TS vs. Control (3/45 vs. 1/62, OR = 4.6, 95% CI = 0.45-46.6, p = 0.19); TS + ADHD vs. Control (7/60 vs. 1/62, OR = 8.5, 95% CI = 0.97-75.2, p = 0.052) | p = 0.19 and 0.05 | TS: 45, TS + ADHD:60 | 65 | Adjusted for gender | Motlagh 2010 [17] |
Maternal smoking | TS + ADHD vs. TS, OR = 2.43 (95% CI: 1.23-4.82) | p = 0.01 | 181 | 172 | Adjusted OR | Pringsheim 2009 [21] |
Maternal smoking | Presence of OCD (OR = 8.27, 95% CI = 0.87-78.20) | p = 0.07 | 180 | Mathews 2006 [26] | ||
Maternal alcohol exposure | TS + ADHD vs. TS, OR = 0.81 (95% CI: 0.46-1.41) | p = 0.45 | 181 | 172 | Adjusted OR | Pringsheim 2009 [21] |
Coffee, cigarettes, alcohol | Male TS vs. Female TS: 47% vs. 50% | NS | 46 M | 7 F | Santangelo 1994 [19] | |
TS + OCD vs. TS: OR = 5.0, 95% CI: 1.3-19.4 | p < 0.05 | 15 | 34 | Santangelo 1994 [19] | ||
Perinatal period | ||||||
Disordered deliveries | (16/42 vs. 14/43) (OR = 1.27, 95% CI = 0.52-3.11) | p = 0.59 | 42 | 43 | Kondo 1982 [15] | |
Any delivery complication | Male TS vs. Female TS: OR = 9.4, 95% CI: 1.01-87.3 | p < 0.05 | 46 M | 7 F | Santangelo 1994 [19] | |
TS + OCD vs. TS: 75% vs. 54% | NS | 15 | 34 | Santangelo 1994 [19] | ||
Operative delivery | TS + ADHD vs. TS, OR = 1.10 (95% CI: 0.71-1.71) | p = 0.66 | 181 | 172 | Unadjusted OR | Pringsheim 2009 [21] |
Forceps delivery | Male TS vs. Female TS: 44% vs. 14% | NS | 46 M | 7 F | Santangelo 1994 [19] | |
TS + OCD vs. TS: OR = 7.9, 95% CI: 3.2-19.5 | p < 0.01 | 15 | 34 | Santangelo 1994 [19] | ||
Perinatal disorders: low BW, Asphyxia, severe vomiting, cyanosis, respiratory distress, jaundice, convulsion, high fever, incubator using, exchange transfusion | 8/43 vs. 9/43, X^2 = 0.07 (OR = 0.86, 95% CI = 0.30-2.50) | NS (p = 0.79) | 43 | 43 | Kondo 1982 [15] | |
Perinatal complications (postnatal jaundice, cord around neck, breech birth, premature birth) | TS + OCS vs. TS only: 5/13 vs. 0/10) | p < 0.01 | 13 | 10 | Fisher's exact test | Iida 1996 [22] |
> 1 hypoxic event | TS vs. Control (17/45 vs. 18/65, OR = 1.4, 95% CI = 0.64-3.3, NS); TS + ADHD vs. Control (18/60 vs. 18/65, OR = 0.9, 95% CI = 0.4-2.2, NS) | NS | TS: 45, TS + ADHD:60 | 65 | Adjusted for gender | Motlagh 2010 [17] |
Apgar 1 | 7.170+/-1.909 vs. 7.517+/-1.623 | p = 0.17 | 53 | 265 | Matched analysis | Burd 1999 [11] |
Apgar 5 | 8.396+/-1.446 vs.8.789+/-1.123 | p = 0.03 | 53 | 265 | Matched analysis | Burd 1999 [11] |
Breathing problems at birth | TS + ADHD vs. TS, OR = 1.95 (95% CI: 0.87-4.37) | p = 0.10 | 181 | 172 | Adjusted OR | Pringsheim 2009 [21] |
Combined pre- and peri-natal periods | ||||||
Total with abnormalities of prenatal and perinatal periods | 19/51 vs. 13/51 (OR = 1.74, 95% CI = 0.74-4.05) | p = 0.20 | 51 | 51 | Pasamanick 1956 [18] | |
Reduced optimality in pre-, peri-, and neonatal periods | No statistical differences between cases and controls (no data provided) in reduced optimality | 25 | 25 | Khalifa 2005 [13] | ||
Pre- and perinatal events | TS (26/48 (54%)), Chronic tics (24/48 (50%)) vs. Control (2/30 (6%)); TS: OR = 16.55 (95% CI = 3.54-77.40); Chronic tics: OR = 14.00 (95% CI = 3.00-65.44) | p < 0.001 (both) | TS: 48, chronic tics: 48 | 30 | Saccomani 2005 [23] | |
Neonatal factors | ||||||
Gestation age | 39.64 (2.73) vs. 40.04 (3.54) | 0.44 | 92 | 460 | Matched analysis | Burd 1999 [11] |
Gestational age (<37 week) | 5/106 vs. 62289/1153363 | 106 | 1153363 | Shimada 2012 [20] | ||
TS + ADHD vs. TS, OR = 3.83 (95% CI: 15.1-9.69) | p < 0.01 | 181 | 172 | Unadjusted OR | Pringsheim 2009 [21] | |
Gestational age (<38 week) | TS: 1/45, TS + ADHD: 6/60, Control: 7/65 | NS | TS: 45, TS + ADHD:60 | 65 | Motlagh 2010 [17] | |
Gestational age (>42 week) | TS: 4/45, TS + ADHD: 4/60, Control: 2/65 | NS | TS: 45, TS + ADHD:60 | 65 | Motlagh 2010 [17] | |
Birth Weight | 3342.2+/- 661.38 vs. 3447.7+/-607.71 | p = 0.14 | 92 | 460 | Matched analysis | Burd 1999 [11] |
TS: 3538+/-530, TS + ADHD: 3438+/-538, Control: 3519+/-755 | NS | TS: 45, TS + ADHD:60 | 65 | Motlagh 2010 [17] | ||
TS vs. Disconcordant Twin: 2228 + -244 vs. 2545 + -216 | p = 0.006 | 6 | 6 | Twins study (paired t test) | Leckman 1987 [16] | |
Low birth weight (<2500 g) | TS vs. Control (1/45 vs. 2/65, OR = 1.3, 95% CI = 0.11-15.4, NS); TS + ADHD vs. Control (3/57 vs. 2/65, OR = 0.55, 95% CI = 0.08-3.7, NS) | NS | TS: 45, TS + ADHD:60 | 65 | adjusted for gender | Motlagh 2010 [17] |
TS vs. Control (1/116 vs. 9162/100097, OR = 0.094) | 116 | 100097 | Shimada 2012 [20] | |||
TS + ADHD vs. TS, OR = 2.74 (95% CI: 1.03-7.29) | p = 0.04 | 181 | 172 | Adjusted OR | Pringsheim 2009 [21] | |
Small for gestational age (<10 percentile) | TS + ADHD vs. TS, OR = 1.13 (95% CI: 0.63-2.04) | p = 0.69 | 181 | 172 | Unadjusted OR | Pringsheim 2009 [21] |
Birth weight above 2500 g | Presence of ADHD, OR = 0.69, 95% CI: 0.52-0.92 | p = 0.02 | 180 | Mathews 2006 [26] | ||
Birth order | X^2 = 2.53 | NS | 43 | 43 | Kondo 1982 [15] | |
First (78/116 vs. 53947/100118), second (34/116 vs. 34594/100118), > = third (8/116 vs. 11577/100118) | 116 | 100118 | Shimada 2012 [20] |